Permit CITY OF TIGARD BUILDING PERMIT
COMMUNITY DEVELOPMENT Permit #: BUP2009 -00211
, Date Issued: 11/24/2009
T t CARL� 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171
Parcel: 2S113AA00700
Jurisdiction: Tigard
Site address: 16600 SW 72ND AVE B10
Subdivision: OREGON BUSINESS PARK 1 Lot: 0
Project: Benchcraft
Project Description: Interior TI partition, ceiling, and ADA.
Owner: FEES
PACIFIC REALTY ASSOCIATES Description Date Amount
15350 SW SEQUOIA PKWY #300 Permit Fee - Additions, Alterations, 11/24/2009 $3,280.35
PORTLAND, OR 97224 Demolition
PHONE: 503 - 624 -6300 12% State Surcharge - Building 11/24/2009 $393.64
Metro Const. Excise Tax - Commercial 11/24/2009 $552.00
Use
Contractor: Plan Review 11/24/2009 $2,132.23
EMERICK CONSTRUCTION CO Plan Review - Fire Life Safety 11/24/2009 $1,312.14
P.O. BOX 66100
PORTLAND, OR 97290
PHONE: 503- 777 -5531
FAX: 503 - 771 -2933
Specifics:
Type of Use: COM
Class of Work: ALT
Dwelling Units:
Stories: 2 Height: ft
Bedrooms: Bathrooms:
Value: $460,000
Floor Areas:
' Total Area:
Accessory Struct:
Basement:
Carport:
Covered Porch:
Deck:
Garage:
Mezzanine:
Total $7,670.36
Required: Required Items and Reports (Conditions)
Fire Sprinkler: Yes Parapet:
Fire Alarm: Yes Protected Corridors: No
Smoke Detectors: Manual Pull Stations:
Accessible Parking:
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. At work will
be do = ' actor• — . - with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is sus•ended for mo he 180
day- ATTENTION: Oreg• • law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules a = forth i R
9 - 001 -0010 through OAR • : • -0 :1. You may obtain a copy of the rules or direct questions to OUNC by calling 503. - •9 o . 00.33 4.
I- ued By: , / / / / Permittee Signature: /
CaII 503.639.4175 by 7:00 a.m. for an inspection that business day.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
,' �
Building Permit Application RECEIVE _ received FOR OFFICE USE ONLY
City of Tigard g Date/By: 8 n`f a9 /-� Permit No.: + /pp 9-zwR /7
13125 SW Hall Blvd., Tigard, OR 97223 NOV 2'4 2009
Er
Plan Review )' /�
Phone: 503.639.4171 Fax: 503.598.1960 DateBy: f t /` �} Other Permit:
TIGARD Inspection Line: 503.639 CITY OF TIGARD Date Ready/By: / !u El See Attached Checklist for
Internet: www.tigard- or.gov BUILDING DIVISION Notified/Method: / ( / : Supplemental Information 44 ,_
TYPE OF WORK REQUIRED DATA: 1- AND 2-FAMILY DWELLING
CD New construction ❑ Demolition Permit fees* are based on the value of the work performed.
Indicate the value (rounded to the nearest dollar) of all
*Addition /alteration/replacement ❑ Other: equipment, materials, labor, overhead, and the profit for the
CATEGORY OF CONSTRUCTION work indicated on this application.
❑ 1- and 2- family dwelling ® Commercial /industrial Valuation: $
❑ Accessory building ❑ Multi- family Number of bedrooms:
❑ Master builder ❑ Other: Number of bathrooms:
JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site address: G'G/J� �Ll, /»ice New dwelling area: square feet
City /State /ZIP: -y-b i I Pr 42 7 9.. 2 Garage /carport area: square feet
Suite/bldg. /apt. no.: Project 4 N 17 Project name: e Covered porch area: square feet
Cross street/directions to job site: Deck area: square feet
7/t L _ - - Jc �/ Other structure area: square feet
40', / REQUIRED DATA: COMMERCIAL -USE CHECKLIST
Subdivision: I Lot no.: Permit fees* are based on the value of the work performed.
Indicate the value (rounded to the nearest dollar) of all
Tax map /parcel no.: equipment, materials, labor, overhead, and the profit for the
VoltIPTION OF WORK work indicated on this application.
Valuation: $ ,�dj � � v
Existing building area: square feet
New building area: square feet
® PROPERTY OWNER ❑ TENANT Number of stories:
Name: PacTrust Type of construction: J//
Address: 15350 S.W. Sequoia Pkwy., Suite 300 Occupancy groups: ���
City /State /ZIP: Portland, OR 97224 Existing: . S , ii .
Phone: (503)624 -6300 Fax: (503)624 -7755 New:
® APPLICANT ® CONTACT PERSON
NOTICE
Business name: PacTrust All contractors and subcontractors are required to be
Contact name: Dennis Pagni licensed with the Oregon Construction Contractors Board
under ORS 701 and may be required to be licensed in the
Address: 15350 S.W. Sequoia Pkwy., Suite 300 jurisdiction in which work is being performed. If the
City /State /ZIP: Portland, OR 97224 applicant is exempt from licensing, the following reasons
apply:
Phone: (503) 624 -6300 Fax: : (503) 624 -7755
E -mail: dennisp @pactrust.com
CONTRACTOR
Business name: x077 e f ,L, lC__ �dN 1 .r,f , L Cr 774e1 BUILDING PERMIT FEES*
Address: (Please refer to fee schedule
City /State /ZIP: Structural plan review fee (or deposit):
Phone: ( ) Fax: ( ) FLS plan review fee (if applicable):
CCB lic.: Total fees due upon application:
Amount received:
Authorized signature: This permit application expires if a permit is not obtained
within 180 days after it has been accepted as complete.
Print name � lr • /7y e� r�� Date ✓J /� ,tG / /��/ * Fee methodology set by Tri -County Building Industry
/� Service Board.
I: \Building \Permits \BUP- PermitApp.doc 03/21/06 440- 4613T(11 /02/COM/WEB)
I i
II ,:. 1 Building Division
TIGARD Over - The - Counter (OTC) Building Permit
Check List
7 Description of Project: ` 14 u e.o.m.,
GENERAL INFORMATION
Class of Work:` J- Floor Areas (sq. ft.): Exterior Wall Construction:
Type of Use:' C-Or7C A First floor: N: S:
Type of Construction: 6.-.2-e Second floor: E: W:
Occupancy Group: Third floor: Openings Protected Y /N ?:
Occupancy Load: F.. Total sq ft.: N: S:
Stories: Note: Combine total floor area E: E:
_ . for _
Height: all floors above third floor and Roof Construction: _ _
Floor Load: add to the third floor sq. ft. Fire Retardant:
Basement: Basement: Area Separation Rated:
Mezzanine: Garage: Occu. Separation Rated:
REQUIRED ITEMS
Fire sprinkler: Ye'rj Handicap access:
Smoke detector: Protected corridors: MO
Fire alarm: YtES Parking spaces ( #):
Notes:
Total Valuation: $ ) Cr:-)
INSPECTIONS FEES DUE
Footing /foundation Firewall $ 32�. ' ' Permit Fee
Post /beam structural Smoke detector $ 3 3.4 State Surcharge
Shear wall Misc. inspection $ 2.1 .23 Plan Review Fee
Masonry Approach /sidewalk $ C '3 (Z. (4 FLS Plan Review Fee
Framing $ Additional Permit Fee
Insulation Sprinkler rough -in $ Additional Plan Review Fee
Gyp board Fire alarm $ Metro Construction Excise Tax
Suspended ceiling Sprinkler final $ School Construction Excise Tax
Final inspection $ Misc. Fee
$ Hourly Rate Fee
$ Hourly Rate State Surcharge
$ 56 Other: H I r / n
$ CJi' Total Fees Due
7 , lP ?o • Ye
''OPTIONS:
TYPE OF USE: COM = commercial; CMS = commercial manufactured structure.
CLASS OF WORK: ACS = accessory; ADD = addition; ALT = alteration; FND = foundation; DEM = demo;
FND = foundation; FPS = fire protection system; NEW = new; OTR = other (use for fences, decks, retaining walls,
signs, awnings or canopies); REP = repair.
I: \Building\Forms \OTC - BUP.doc 08/19/08